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[1]許金海,楊愛(ài)民,施問(wèn)民,等.活血化瘀類中藥治療神經(jīng)根型頸椎病有效性和安全性的系統(tǒng)評(píng)價(jià)[J].中醫(yī)正骨,2019,31(12):20-28.
 XU Jinhai,YANG Aimin,SHI Wenmin,et al.Clinical efficacy and safety of blood act stasis remov drugs for treatment of cervical spondylotic radiculopathy:a systematic review[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(12):20-28.
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活血化瘀類中藥治療神經(jīng)根型頸椎病有效性和安全性的系統(tǒng)評(píng)價(jià)()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期數(shù):
2019年12期
頁(yè)碼:
20-28
欄目:
文獻(xiàn)研究
出版日期:
2019-12-20

文章信息/Info

Title:
Clinical efficacy and safety of blood act stasis remov drugs for treatment of cervical spondylotic radiculopathy:a systematic review
作者:
許金海1楊愛(ài)民2施問(wèn)民2王晶1王國(guó)棟1周曉寧1匡昱林1喬嬌嬌1葉潔1莫文1施杞1
(1.上海中醫(yī)藥大學(xué)附屬龍華醫(yī)院,上海 200032; 2.上海市浦東新區(qū)浦南醫(yī)院,上海 200125)
Author(s):
XU Jinhai1YANG Aimin2SHI Wenmin2WANG Jing1WANG Guodong1ZHOU Xiaoning1KUANG Yulin1QIAO Jiaojiao1YE Jie 1MO Wen1SHI Qi1
1.Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China2.Shanghai Punan Hospital of Pudong New District,Shanghai 200125,China
關(guān)鍵詞:
活血祛瘀藥 神經(jīng)根型頸椎病 Meta分析 系統(tǒng)評(píng)價(jià)
Keywords:
blood act stasis remov drugs cervical spondylotic radiculopathy meta-analysis systematic review
摘要:
目的:系統(tǒng)評(píng)價(jià)活血化瘀類中藥治療神經(jīng)根型頸椎病(cervical spondylotic radiculopathy,CSR)的有效性和安全性。方法:計(jì)算機(jī)檢索Cochrane Library、PubMed、EMbase、CNKI、萬(wàn)方數(shù)據(jù)庫(kù)、維普全文期刊數(shù)據(jù)庫(kù)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)光盤數(shù)據(jù)庫(kù),檢索年限均設(shè)定為建庫(kù)至 2019年1月31日。對(duì)納入的文獻(xiàn)進(jìn)行方法學(xué)質(zhì)量評(píng)估并提取有效數(shù)據(jù),采用Revman5.3軟件進(jìn)行Meta分析。結(jié)果:系統(tǒng)評(píng)價(jià)共納入41篇文獻(xiàn),涉及4079例受試者。Meta分析結(jié)果顯示,活血化瘀類中藥治療CSR的總有效率高于西藥治療[I2=0%,OR=2.90,95%CI(1.98,4.26)]; 活血化瘀類中藥結(jié)合非藥物療法治療CSR的總有效率高于非藥物療法[I2=0%,OR=4.13,95%CI(2.97,5.75)]; 活血化瘀類中藥治療CSR的治愈率高于西藥治療[I2=27%,OR=2.32,95%CI(1.67,3.24)]; 活血化瘀類中藥結(jié)合非藥物療法治療CSR的治愈率高于非藥物療法[I2=0%,OR=2.38,95%CI(1.85,3.07)]; 活血化瘀類中藥治療CSR的治療后疼痛視覺(jué)模擬量表(visual analogue scale,VAS)評(píng)分低于安慰劑治療[I2=87%,MD=-13.56,95%CI(-22.44,-4.68)]; 活血化瘀類中藥與西藥治療CSR的治療后疼痛VAS評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義[I2=76%,MD=-0.33,95%CI(-0.89,-0.23)]; 活血化瘀類中藥結(jié)合非藥物療法治療CSR的治療后疼痛VAS評(píng)分低于非藥物療法[I2=96%,MD=-1.38,95%CI(-1.92,-0.84)]; 活血化瘀類中藥治療CSR的治療后頸椎功能障礙指數(shù)(neck disability index,NDI)低于安慰劑治療[I2=0%,MD=-3.26,95%CI(-4.96,-1.55)]; 活血化瘀類中藥與西藥治療CSR的治療后神經(jīng)根型頸椎病療效評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義[I2=95%,OR=0.96,95%CI(-0.65,2.57)]。活血化瘀類中藥造成的不良反應(yīng)較輕,且少于消炎止痛類西藥。結(jié)論:現(xiàn)有證據(jù)表明,活血化瘀類中藥治療CSR總體療效較好,且較為安全。
Abstract:
Objective:To systematically review the clinical efficacy and safety of blood act stasis remov drugs for treatment of cervical spondylotic radiculopathy(CSR).Methods:The articles included from database establishing to January 31,2019 were retrieved from Cochrane Library,PubMed,EMbase,CNKI,WanFang Database,Vip database and CBMdisc through computer.The methodological quality of research in the articles was evaluated and the valid data were extracted and a Meta-analysis was conducted by using Revman5.3 software.Results:Forty-one articles(4079 patients)were included in the final analysis.The results of Meta-analysis demonstrated that the total effective rate was higher in patients who received blood act stasis remov drugs compared to patients who received western medicine and was higher in patients who received combination of blood act stasis remov drugs with non-drug therapy compared to patients who received non-drug therapy for treatment of CSR(I2=0%,OR=2.90,95%CI(1.98,4.26); I2=0%,OR=4.13,95%CI(2.97,5.75)).The cure rate was higher in patients who received blood act stasis remov drugs compared to patients who received western medicine and was higher in patients who received combination of blood act stasis remov drugs with non-drug therapy compared to patients who received non-drug therapy for treatment of CSR(I2=27%,OR=2.32,95%CI(1.67,3.24; I2=0%,OR=2.38,95%CI(1.85,3.07)).The posttreatment pain visual analogue scale(VAS)scores were lower in patients who received blood act stasis remov drugs compared to patients who received placebo for treatment of CSR(I2=87%,MD=-13.56,95%CI(-22.44,-4.68)).There was no statistical difference in posttreatment pain VAS scores between patients who received blood act stasis remov drugs and patients who received western medicine for treatment of CSR(I2=76%,MD=-0.33,95%CI(-0.89,-0.23)).The posttreatment pain VAS scores were lower in patients who received combination of blood act stasis remov drugs with non-drug therapy compared to patients who received non-drug therapy for treatment of CSR(I2=96%,MD=-1.38,95%CI(-1.92,-0.84)).The posttreatment neck disability index(NDI)was lower in patients who received blood act stasis remov drugs compared to patients who received placebo for treatment of CSR(I2=0%,MD=-3.26,95%CI(-4.96,-1.55)).There was no statistical difference in posttreatment efficacy scores between patients who received blood act stasis remov drugs and patients who received western medicine for treatment of CSR(I2=95%,OR=0.96,95%CI(-0.65,2.57)).The adverse reactions caused by blood act stasis remov drugs were slighter and less than those caused by analgesics anti-inflammatory.Conclusion:Available evidence suggests that blood act stasis remov drugs are effective and safe for treatment of CSR.

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基金項(xiàng)目:國(guó)家自然科學(xué)基金項(xiàng)目(81603635); 上海市科學(xué)技術(shù)委員會(huì)科研計(jì)劃項(xiàng)目(17401934400,19401901100); 上海申康醫(yī)院發(fā)展中心項(xiàng)目(16CR4011A); 上海市進(jìn)一步加快中醫(yī)藥事業(yè)發(fā)展三年行動(dòng)計(jì)劃項(xiàng)目 [ZY(2018-2020)-FWTX-4002]通訊作者:莫文 E-mail:[email protected](收稿日期:2019-10-13 本文編輯:李曉樂(lè))
更新日期/Last Update: 2019-12-15